Abstract

The Syndrome of Broca’s dysphasia often evolves over a period of months and sometimes years from an initial stage of global dysphasia, but may occasionally appear in its own right as an acute dysphasia. In the completely developed picture of Broca’s dysphasia, spontaneous speech is nonfluent and agrammatic, while auditory comprehension is preserved at levels adequate for understanding most conversation and even at nearly normal levels in some patients. Sentence repetition is seriously impaired, although repetition of one- or two-word segments may be possible. Writing is usually on a par with speech. Reading aloud parallels the limited Output of spontaneous speech but reading for meaning, though sometimes slow and painstaking, is usually preserved at the level of auditory comprehension. Naming on visual confrontation is often slightly superior to the ability to generate names in spontaneous speech or in response to word definitions. Right hemiparesis affecting the arm more than the leg, buccofacial apraxia, and ideomotor apraxia of the motorically spared left Upper extremity are common. In the acute stage, if the initial deficit of auditory comprehension is mild, disturbances of writing are minimal and hemiparesis is not marked, and rapid improvement from a State of severe nonfluency is to be expected over several days or weeks. In these latter patients, agrammatism, as measured in handwriting samples or in a story completion task in which the patient is required to supply the proper grammatical form of a word that completes a sentence, is not prominent.